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Individual

DR. BONNIE LUCILLE DAMRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W.

Contact information

Practice address
600 ROOSEVELT BLVD APT G2, FALLS CHURCH, VA 22044-3129
(703) 538-4289
Mailing address
600 ROOSEVELT BLVD APT G2, FALLS CHURCH, VA 22044-3129
(703) 538-4289

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001215
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0904001215
STATE LICENSE NUMBER
VA
Enumeration date
12/17/2006
Last updated
07/08/2007
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